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Management of right atrial appendage (RAA) thrombus is a clinical dilemma. We describe a case of incidentally found RAA thrombus in a patient with a left atrial appendage closure device (WATCHMAN). Options for the management of RAA thrombus include observation, anticoagulation, thrombolytics, or surgical extraction. Size, mobility, site of attachment of the thrombi, patient factors (e.g., bleeding risk), and other indications for anticoagulation may be used to guide management.
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http://dx.doi.org/10.1080/08998280.2022.2065104 | DOI Listing |
J Thorac Cardiovasc Surg
September 2025
Population Health Research Institute, Hamilton Health Sciences, McMaster University, Ontario, Canada.
Objective: Societal guidelines recommend vitamin K antagonists (VKAs) for atrial fibrillation patients with recent biological valve implantation, but the safety and efficacy of direct oral anticoagulants (DOACs) in this setting remain uncertain, especially in the early postoperative period. This substudy of the Left Atrial Appendage Occlusion Study (LAAOS) III trial aimed to compare thromboembolic and bleeding outcomes in patients discharged on VKAs versus DOACs after bioprosthesis implantation or mitral valve repair.
Methods: A total of 2,645 patients were included, with 461 discharged on DOACs and 2184 on VKAs.
Prog Cardiovasc Dis
September 2025
Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
Left atrial appendage (LAA) closure has emerged as a critical therapeutic option for stroke prevention in patients with atrial fibrillation who are unsuitable for long-term oral anticoagulation. Multimodality imaging plays a pivotal role throughout the LAA closure process, from pre-procedural planning to long-term follow-up. This review focuses on the complementary roles of cardiac computed tomography (CCT) and transesophageal echocardiography (TEE), outlining their respective strengths and limitations in various phases of LAA management, while also discussing the roles of intracardiac echocardiography (ICE) and fluoroscopy.
View Article and Find Full Text PDFMol Biol Rep
September 2025
Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, 91766-1854, USA.
Regenerative cardiology has emerged as a novel strategy to improve cardiac healing following ischemic injury. While stem-cell-mediated cardiac regeneration has garnered much attention as a promising strategy, its value remains debated owing to the lack of ideal stem cell source candidates. Resident/endogenous cardiac-derived stromal cells (CSCs) exhibit superior therapeutic potential due to their innate abilities to differentiate into cardiac cells, especially cardiomyocytes (CM).
View Article and Find Full Text PDFJAMA Netw Open
September 2025
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock.
Importance: Patients with kidney failure (KF) receiving long-term dialysis have increased incidence of atrial fibrillation (AF). Patients with KF and AF have increased risk of stroke, death, and bleeding compared with age-matched cohorts. In KF, the use of oral anticoagulants (OACs) increases hemorrhage risk, offsetting potential benefits and making left atrial appendage occlusion (LAAO) a potentially promising solution for risk reduction in AF.
View Article and Find Full Text PDFJACC Cardiovasc Imaging
September 2025
Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. Electronic address:
Background: Residual leaks are common after left atrial appendage occlusion (LAAO).
Objectives: The authors aimed to systematically evaluate the prognostic implications of residual left atrial appendage (LAA) patency and peridevice leaks (PDLs) detected by cardiac computed tomography (CT) following LAAO.
Methods: The authors used traditional meta-analytical methods and a Bayesian framework to assess the probability of increased risks associated with these residual leaks.